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The use of immunosuppression therapies in Neurology has extended exponentially since they were first used in the 1970s for myasthenia gravis. However there are no NICE or neurology specific guidelines in this area for Neurologists to refer to in their clinical practice.This 2014 retrospective case notes audit compared medical documentation to ‘10 key statements’ pertaining to the safe use and monitoring of immunosuppression therapies. This is a framework for clinical practice that was first published by The British Association of Rheumatology and The British Association of Dermatology in 2008.A number of key areas of poor documentation around drug safety, pregnancy and vaccinations were identified and in response generic and drug specific safety ‘check-lists’ and guidelines were produced, to be filled out with all patients, prior to starting therapies.In 2016 following the implementation of the quality improvement project, a repeat audit of patient’s medical notes showed a clear improvement in documentation.Drug specific guidelines led to an improvement in documentation and we believe that this also reflects safer prescribing and improved clinical practice. We are now in the process of developing guidelines to be used throughout the entire Northern Deanery.